3 ms·

>Where's the money in a 50 (or even 1k) tailored vaccine to cure a cancer when a slightly new combination of cancer drugs can cost $50,000 a month for the rest

>Where's the money in a 50 (or even 1k) tailored vaccine to cure a cancer when a slightly new combination of cancer drugs can cost $50,000 a month for the rest of the life of a patient? Profit isn't revenue, for one thing. Does that hypothetical $50k/month treatment cost $49,999/month to manufacture? That's the story for a lot of drugs.

vkou 4y ago
Hypothetically, yes. Practically, that almost never happens. The reason the treatment costs $50k/month is because there is no alternative, and that's how much insurance will pay for it. Whether or not the unit economics are $49,999/month or $49/month has no bearing on this. Treatments aren't commodities, they aren't apples at the grocer, where if the prices are too high, you just go to a competitor across the street.
- killjoywashere 4y ago
  Ok, so here's a thought: who makes money if people don't die of cancer? Let's assume they're all retirees. Agriculture, housing, the local taxation authority, and possibly their immediate kin (assuming, on average, people love their parents and want to spend time with them). Maybe Monsanto, Toll Brothers, and local governments should be funding cancer research?
- dekhn 4y ago
  I work in pharma. Pricing in pharma for drugs like that is complicated. Usually these drugs do actually require rather expensive manufacturing processes, that have to run in extremely large facilities with extensive QA, but in fairly small batches. More importantly, every major pharma has a compassionate use program that helps people who can't afford the drugs get them, through offsets and credits. I understand the desire to make pharma look like pure-evil profit mongers, but the reality is that this is not an easy business to be in.
  - cmeacham98 4y ago
    Many drugs invented by US companies are available cheaper in countries that don't respect US IP law (with no differences in quality/QA process/etc). The reason for this is obvious: in the US the government gives the inventor a temporary monopoly. It's pretty widely accepted the presence of this government-enforced monopoly significantly increases the price of many drugs. The standard argument in favor of this is that it incentivizes R&D and we wouldn't have these drugs otherwise. I think it's debatable either way, but claiming these companies don't take advantage of this arrangement to increase prices is not true.
    - _0w8t 4y ago
      The price of drugs in US also reflects expensive R&D and sometimes even more expensive approval process. Plus the companies has to account for the possibility of third parties manufacturing without the license which in turn requires higher unit price.
    - rswail 4y ago
      This is nonsense. Most Western nations fully respect IPR and patents. There is nothing wrong with patents "promoting the Arts and Sciences". The problem in the US is that your largest buyers (Medicare, Medicaid, VA, Tricare) aren't allowed to properly use their buying power to push pharma companies on prices. At the same time, there's very little restriction on pharma companies advertising directly to patients (banned in most nations) which puts pressure on GPs and specialists to over/off-label prescribe unnecessary pharma. Prices in most countries are cheaper than the US because of that buying power that the government has, along with independent assessment of the value of new drugs and treatments in terms of QALY and cost/benefit to the people.
    - dekhn 4y ago
      I am not aware of any large-scale alternative manufacturing facilities that explicitly avoid IP laws and market their product legally. Can you give an example? I work for a US biotech that is wholly owned by a EU pharma, not the US.
  - erosenbe0 4y ago

vkou 4y ago

Hypothetically, yes. Practically, that almost never happens. The reason the treatment costs $50k/month is because there is no alternative, and that's how much insurance will pay for it. Whether or not the unit economics are $49,999/month or $49/month has no bearing on this. Treatments aren't commodities, they aren't apples at the grocer, where if the prices are too high, you just go to a competitor across the street.

killjoywashere 4y ago
Ok, so here's a thought: who makes money if people don't die of cancer? Let's assume they're all retirees. Agriculture, housing, the local taxation authority, and possibly their immediate kin (assuming, on average, people love their parents and want to spend time with them). Maybe Monsanto, Toll Brothers, and local governments should be funding cancer research?
dekhn 4y ago
I work in pharma. Pricing in pharma for drugs like that is complicated. Usually these drugs do actually require rather expensive manufacturing processes, that have to run in extremely large facilities with extensive QA, but in fairly small batches. More importantly, every major pharma has a compassionate use program that helps people who can't afford the drugs get them, through offsets and credits. I understand the desire to make pharma look like pure-evil profit mongers, but the reality is that this is not an easy business to be in.
- cmeacham98 4y ago
  Many drugs invented by US companies are available cheaper in countries that don't respect US IP law (with no differences in quality/QA process/etc). The reason for this is obvious: in the US the government gives the inventor a temporary monopoly. It's pretty widely accepted the presence of this government-enforced monopoly significantly increases the price of many drugs. The standard argument in favor of this is that it incentivizes R&D and we wouldn't have these drugs otherwise. I think it's debatable either way, but claiming these companies don't take advantage of this arrangement to increase prices is not true.
  - _0w8t 4y ago
    The price of drugs in US also reflects expensive R&D and sometimes even more expensive approval process. Plus the companies has to account for the possibility of third parties manufacturing without the license which in turn requires higher unit price.
  - rswail 4y ago
    This is nonsense. Most Western nations fully respect IPR and patents. There is nothing wrong with patents "promoting the Arts and Sciences". The problem in the US is that your largest buyers (Medicare, Medicaid, VA, Tricare) aren't allowed to properly use their buying power to push pharma companies on prices. At the same time, there's very little restriction on pharma companies advertising directly to patients (banned in most nations) which puts pressure on GPs and specialists to over/off-label prescribe unnecessary pharma. Prices in most countries are cheaper than the US because of that buying power that the government has, along with independent assessment of the value of new drugs and treatments in terms of QALY and cost/benefit to the people.
  - dekhn 4y ago
    I am not aware of any large-scale alternative manufacturing facilities that explicitly avoid IP laws and market their product legally. Can you give an example? I work for a US biotech that is wholly owned by a EU pharma, not the US.
- erosenbe0 4y ago